Notifying a doctor of a first hypoglycaemic episode is associated with a lower rate of recurrence among inpatients with diabetes

February 10, 2014

Med J Aust 2014; 200 (2): 79.

doi:10.5694/mja13.11014

Authors: Dilantha T De Alwis, Suresh Varadarajan, Kwang Lim

To the Editor: Hypoglycaemia is a common problem in inpatients with diabetes and is associated with morbidity and mortality.1,2 We conducted a retrospective single-centre cohort study to evaluate the management (notifying a doctor and taking appropriate preventive actions, defined as altering the hypoglycaemic agent that led to the event or commencing dextrose in appropriate cases by the doctor) of the first hypoglycaemic episode and its impact on recurrence and length of stay.

We evaluated the first hypoglycaemic episode (capillary glucose level < 3.5 mmol/L) of all 915 patients with diabetes admitted to our inpatient ward over 3 months, from January to March 2012. One hundred patients experienced one or more hypoglycaemic episodes and, of these, 57 experienced recurrences. For 19 patients, a doctor was notified of the first episode. Recurrence was seen in six of these patients, compared with 51 of the 81 patients for whom a doctor was not notified of the first episode (P = 0.013). Severe hypoglycaemia (< 2.5 mmol/L) was seen in 11/19 patients during the first episode in the doctor-notified group and in 18/81 patients in the doctor-not-notified…